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. 2017 Nov 1;68(11):1193-1196.
doi: 10.1176/appi.ps.201600538. Epub 2017 Jul 17.

Medicare Accountable Care Organizations and Antidepressant Use by Patients With Depression

Alisa B Busch  1 , Haiden A Huskamp  1 , Amanda R Kreider  1 , J Michael McWilliams  1
Affiliations

Medicare Accountable Care Organizations and Antidepressant Use by Patients With Depression

Alisa B Busch et al. Psychiatr Serv. .

Abstract

Objective: This study examined whether Medicare accountable care organization (ACO) programs were associated with early changes in antidepressant use or adherence among beneficiaries with depression.

Methods: A difference-in-difference design was used to compare claims from Medicare fee-for-service beneficiaries (2009-2013) and ACO patients with those from local control groups. Outcome measures were total antidepressant days supplied, filling one or more antidepressant prescriptions, and proportion of days covered (PDC) by supply among antidepressant users (adherence).

Results: Among antidepressant users, ACO contracts were associated with slight differential increases in PDC (.4-.8 percentage point, p≤.03), depending on ACO program and entry year. The proportion of patients with one or more prescriptions was unchanged or decreased slightly for ACO patients with depression, such that total supply did not consistently increase.

Conclusions: Medicare ACO programs were associated with early modest increases in antidepressant adherence but not with increases in the proportion of patients with depression who received antidepressants.

Keywords: Medicare; Quality of care; Service delivery systems; accountable care organizations.

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References

    1. Muhlestein D, Gardner P, Caughey W, et al. Projected Growth of Accountable Care Organizations: Leavitt Partners. 2015.
    1. Baseman SBC, Moon M, Griffin S, Dutta T. Payment and Delivery System Reform in Medicare: A Primer on Medical Homes, Accountable Care Organizations, and Bundled Payments. Menlo Park, CA: Kaiser Family Foundation; [updated 2016 May; cited 2016 Oct 28]. Available from: http://kff.org/medicare/report/payment-and-delivery-system-reform-in-med...
    1. Centers for Medicare and Medicaid Services. Next Generation Accountable Care Organization Model (Next Generation ACO Model) Fact Sheet. Washington, D.C: [cited 2017 Apr 5]. Available from: https://innovation.cms.gov/Files/fact-sheet/nextgenaco-fs.pdf.
    1. Centers for Medicare and Medicaid Services. Fast Facts: All Medicare Shared Savings Program Accountable Care Organizations. Washington, D.C: [updated 2017 Jan; cited 2017 Apr 5]. Available from: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavi....
    1. McWilliams JM. Changes in Medicare Shared Savings Program savings from 2013 to 2014. JAMA. 2016;316:1711–3. - PMC - PubMed

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